Pelvic organ prolapse is known as a disease with a symptom that one or more organs placed in a pelvis, such as an uterus, an urinary bladder, an urethra, a small intestine, and a rectum, drop into vagina and slip out from a female genital with a vaginal wall.
Pelvic organ prolapse may also called “uterine prolapse”, “cystocele”, “urethrocele”, “enterocele”, or “rectocele” depending on the slipping organ. Collectively, they are called “pelvic organ prolapse (genital prolapse)”.
In general, pelvic organ prolapse is regarded as not being life-threatening.
However, the slipping out of pelvic organ(s) from vagina may cause a drying in the air, an abrasion, and even a bleeding of mucous membrane, thereby making it difficult for a patient to walk. Particularly, the slipping out of an urinary bladder affects an urethra and causes a certain symptom such as urinary incontinence or difficulty of urination. In addition, the slipping out of a rectum may cause difficulty in defecating. Thus, pelvic organ prolapse is one of so-called QOL (Quality Of Life) diseases which may cause a great deal of discomfort and distress in the patient's daily life. It is said that pelvic organ prolapse is a very common condition, particularly among postmenopausal women, and it is estimated in abroad that half of women aged 50 or over will experience some form of prolapse.
It is thought to be causally related to this disease that pelvic floor muscles supporting pelvic organs (an uterus, an urinary bladder, an urethra, a small intestine, and a rectum) become weak, loose or damaged mainly due to childbirth and can no longer support the pelvic organs. The other cases are seen in a situation where a chronic abdominal pressure is applied in case of asthma, hay fever, occupational standing work, engagement in agriculture, yard work, some kind of sport, constipation, obesity, or the like.
Pelvic organ prolapse is classified into first to fourth grades depending on how far the pelvic organ has fallen, each defined as dropping into vagina (stage I), reaching to vaginal opening (stage II), partly slipping out from vagina (stage III), and entirely slipping out from vagina (stage IV).
There have been known two method for treating pelvic organ prolapse; (1) one is a curative treatment by surgical operation; and (2) the other is a treatment by using a ring pessary.
The surgical operations of (1) includes: anterior vaginal wall plasty, vaginal total hysterectomy, posterior vaginal wall plasty, Manchester operation, sacrospinous ligament fixation of vaginal apex, musculus iliococcygeus fasciodesis (Inmon procedure), and sacrouterine ligament fixation (McCall technique), as vaginal operation; abdominal sacrocolpopexy as abdominal operation; laparoscopic sacrocolpopexy as laparoscopic operation; and Le Fort operation as colpocleisis. In addition, most recently, as an operation method enabling to reduce relapse rate, TVM (Tension free Vaginal Mesh) procedure using a gynemesh is proposed.
The ring pessary of (2) is provided as a toroidal shaped ring to be inserted into vagina. The ring pessary prevents the organs to drop by lifting up vagina.